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A technique is proposed and evaluated for predicting the confusability of elements of an aural message transmitted by native English speakers against a noise background. The results suggest that a relatively simple comparison of the phonemic elements of a message with correspondingly located elements of other possible messages in a communication link allows a good prediction of potential confusions between correspondingly located segments of messages.

Diffuse renal cortical necrosis from any cause is rare in the Western World. Over the last 5 decades, there have been isolated case reports of acute cortical necrosis as a consequence of acute pancreatitis, but the long-term outcome of these patients has not previously been reported. Here, we report 3 young men, aged 16 - 21 years, who have presented over the past 19 years with severe acute pancreatitis associated with oliguric acute renal failure. They were all found to have diffuse renal cortical necrosis and consequently made no renal recovery. Despite the appreciable mortality associated with acute pancreatitis complicated by acute renal failure, they all survived the initial illness and all have successfully undergone renal transplantation. We present a detailed account of each patient including diagnostic strategies and discuss the possible factors contributing to a favorable outcome in these patients.

Necropsy of 2 white-tailed deer fawns who died acutely revealed diarrhea and melena in case No. 1 and no gross changes in case No. 2. Histologically, the livers of both deer displayed multifocal coagulative necrosis, with infiltrations of neutrophils, macrophages, and lymphocytes. By Warthin-Starry staining, bundles of filamentous bacteria were identified within hepatocytes at the periphery of the necrotic foci in case No. 1. There was multifocal myocardiocyte necrosis in case No. 1 and multifocal lymphoid necrosis of the Peyer's patches in case No. 2. Clostridium piliforme 16S ribosomal ribonucleic acid gene was detected in both livers by polymerase chain reaction (PCR) with C. piliforme-specific primers. The liver copper levels in both cases were normal to slightly elevated. The kidney copper level in case No. 2 was elevated. This represents the first published cases of Tyzzer's disease in deer, a novel use of PCR for the diagnosis of C piliforme infection, and a possible association between copper toxicosis and Tyzzer's disease.

To isolate novel cellular factors that are activated or repressed upon WSV infection, the RNA fingerprints of healthy and WSV infected blue shrimp ( Penaeus stylirostris) were compared using the mRNA differential display technique. Thirty-two unique differentially expressed, and one constitutively expressed, cDNA sequences were retrieved. Six of 32 cDNAs showed similarities with the database entries: cDNA 10G32-142 to a shrimp arginine kinase, 22C48-201 to shrimp mitochondrial ATPase gene; 22C47-197, 21G49-203 and 20A55-268 to shrimp ESTs and 20G50-206 to a WSV gene, ORF 116. The constitutively expressed gene showed significant similarity to a yeast elongation factor 1-alpha gene. The expression of a subset of differentially expressed genes (13 of 32) was further evaluated by real-time RT-PCR. Ten of 13 genes showed statistically significant changes in expression between healthy and WSV infected animals suggesting that these genes may play an important role in WSV pathogenesis.

Introduction Background. The object of the study was to develop an artificial neural network (ANN ) to identify patients In the West of Scotland, 23% of patients with IgA with IgA nephropathy (IgAN ) with a poor prognosis nephropathy (IgAN ) will have developed end-stage and to compare the predictions of the ANN with the chronic renal failure ( ESCRF ) after 10 years of followpredictions of six experienced nephrologists. up [1]. IgAN accounted for 26% of all men with Methods. The following data from the time of renal histologically diagnosed glomerulonephritis starting biopsy were retrieved from the records of 54 patients renal replacement therapy in Europe in 1992 [2]. with IgAN: age, sex, systolic and diastolic blood pres- Epidemiological studies have demonstrated that male sure, number of prescribed antihypertensive drugs, sex, high levels of proteinuria, hypertension, and elev24-h urine protein excretion, and serum creatinine. ated serum creatinine at presentation are all associated Patients aged less than 14 years, or who had serum with development of progressive disease [3]. However, creatinine >350 mmol/l at presentation, liver disease it is diYcult for the nephrologist to predict which or concomitant kidney disease were excluded. Outcome individuals with IgAN will develop progressive renal was assigned as ‘stable’ if serum creatinine was failure at the time they present. The ability to identify

Twenty-four young adult domestic cats from a commercial vendor were found to be infected with Helicobacter pylori. Histopathologic analyses, selected electron microscopy, and urease mapping were performed on mucosal samples collected from the cardias and fundi, bodies, and antra of these cats' stomachs. H. pylori organisms were abundant in all areas of the stomach on the basis of histologic evaluation and urease mapping. H. pylori infection was associated with a moderate to severe lymphofollicular gastritis in 21 of 24 cats (88%). The gastritis was most pronounced in the antral region and consisted mainly of multifocal lymphoplasmacytic follicular infiltrates in the deep mucosa. The severity of gastritis in the antrum corresponded to high numbers of H. pylori there on the basis of the use of the urease assay as an indicator of H. pylori colonization. Ten of 24 cats (42%) also had small to moderate numbers of eosinophils in the gastric mucosa. All 24 cats had gastric lymphoid follicles, with follicles being most prevalent in the antrum. Electron microscopy of gastric tissue revealed numerous H. pylori organisms, some of which were closely adhered to the mucosal epithelium. Human H. pylori gene-specific primers to ureA and ureB amplified products of similar sizes from H. pylori cat isolates. Digestion of the products with restriction enzymes resulted in fragments characteristic of the restriction fragment length polymorphism patterns of H. pylori isolates from humans. In the domestic cat, H. pylori infection is associated with a lymphofollicular gastritis, consisting of lymphocytic and plasmacytic infiltration into the lamina propria, and the organism appears to provide chronic antigenic stimulation resulting in the formation of gastric lymphoid follicles.

Several inbred strains of mice in closed breeding colonies were found to have spiral-shaped bacteria associated with active, chronic hepatitis. A new species of Helicobacter, H. hepaticus, was isolated from the infected livers of some strains of mice. Other strains of mice were colonised with H. hepaticus in the caecum and colon, but not the liver. Filtersterilised supernatant fluid from five strains of H. hepaticus was tested in a mouse liver cell line (ATCC no. CCL 9.1) for cytotoxic activity. All strains produced a toxic factor causing morphological changes in the cells at dilutions up to 1 in 1000. Toxicity was observed after exposure to the supernatant fluid for 48-72 h. Other Helicobacter spp. that also produced the cytopathic effect (CPE) in the liver cell line were H. felis, H. acinonyx, H. pylori and one strain of H. mustelae. "Helicobacter rappini" and H. muridarum did not cause CPE in the liver cells. The soluble factor was stable at 4 degrees C for up to 3 months. It was also stable at 56 degrees C for 30 min, but was inactivated by boiling for 15 min. It was inactivated by incubation with trypsin. A partially purified preparation of the cytotoxin had a mol. wt of c. 100,000 and did not have urease activity. The cytotoxin produced by H. hepaticus did not cause vacuole formation in HeLa cells.

1. Glomerular charge selectivity was assessed using the ratio of the clearance of pancreatic isoamylase to the clearance of the more anionic salivary isoamylase (CPAm/CSAm) in 53 patients with primary glomerulopathies (minimal change nephropathy, idiopathic membranous nephropathy, IgA nephropathy) and a wide range of albumin excretion rates and in 31 healthy subjects. Fractional clearances of pancreatic and salivary isoamylases (FCPAm, FCSAm) and of albumin (FCAlb) were also measured. 2. CPAm/CSAm and FCPAm were negatively correlated with FCAlb for the whole patient group (rs = −0.56 and rs = −0.65, respectively, P < 0.0001 for both), but there was no correlation of FCSAm with FCAlb. 3. For patients with near-normal albumin excretion rates (< 100 mg/24 h), there was no difference in CPAm/CSAm between the three types of glomerulopathy or between patients and healthy subjects. 4. These data suggest that glomerular charge selectivity at the size of amylase (which is smaller than albumin) is progressively lost as albuminuria increases from normal to the nephrotic range. Size restriction progressively increases until albuminuria is very heavy. When the albumin excretion rate is near normal, charge selectivity is also normal in the three main forms of primary glomerulopathy.

This is a retrospective analysis of all patients with a raised titre of ANCA in a single centre over a two-year period. Sixty-five patients were identified and clinical data is presented for 58 of these — 34 male and 24 female. The median age is 56 years (13–83). Fourteen patients had Wegener's granulomatosis, 14 microscopic polyarteritis nodosa and 30 had other diagnoses. The patients with unexpectedly positive results are discussed in detail. This study confirms the sensitivity of ANCA in Wegener's granulomatosis and microscopic polyarteritis nodosa but suggests that the test is not as specific as initially claimed.

Gastric malignancy was the cause of bleeding in 35 of a consecutive series of 2260 cases (1.5%) treated with upper gastrointestinal haemorrhage. Fifteen patients came to emergency surgery (43%). In 13 of 30 early endoscopies performed the lesion was thought to be benign (43%) and seven of these cases came to emergency surgery. Two patients died after 15 emergency operations (13%) compared with 15 deaths after 109 emergency operations (14%) for benign gastric ulcer during the same period of study. A total of four patients with malignant ulceration died after surgery in 33 cases (12%), two after 15 emergency operations and two after 18 elective procedures. The only significant predictors of urgent surgery for malignant ulcer were shock on admission and active bleeding or visible vessel on endoscopy. Resection of gastric malignancy was performed in 29 patients during initial admission and in four cases at a subsequent admission giving a final resection rate of 91%. Of the 28 patients with adenocarcinoma, 19 had localized disease (Stage I or II) (68%). Nine patients were treated by total gastrectomy, five at an initial elective procedure and four at a second procedure.

We examined 28 suckling, weanling, and young adult rabbits with lethargy, inappetence, and mucinous, semifluid feces. Sixteen of the rabbits had intestinal lesions. In eight of these rabbits, the primary changes were multifocal to diffuse epithelial proliferation and accumulation of lymphocytes, macrophages, or both in the lamina propria of the small intestine, cecum, and sacculated colon. In two of these rabbits, the accumulation of macrophages in the lamina propria was extensive. The other eight rabbits had erosive and suppurative cecocolitis, and four of the rabbits with proliferative lesions also had suppurative cecocolitis. In Warthin-Starry-stained sections of affected intestine, curved or spiral bacteria were visible within degenerated or hyperplastic epithelium, in luminal exudate, or in both. Such organisms were sparse or not found in the other 12 rabbits, which did not have intestinal lesions. The bacteria ultrastructurally resembled intraepithelial Campylobacter-like bacteria previously observed in proliferative enteritis in a variety of species and in acute typhlitis in young rabbits. In immunofluorescence tests, Campylobacter-like bacteria in epithelial cells, crypt lumina, and in luminal exudates in both proliferative and erosive lesions bound monoclonal antibodies and polyclonal antisera prepared against intracellular bacteria found in proliferative enteritis in pigs, hamsters, and ferrets. These observations indicate that a condition similar to proliferative enteritis of swine, hamsters, and other species also occurs in laboratory rabbits.

Key words: inferior vena cava thrombosis; nephrotic (Figure 1). This was confirmed by transoesophagealsyndrome; membranous nephropathy; intrathrombic echocardiography.rt-PA lysis On advice from a haematologist, treatment wasstarted with streptokinase 600000 units i.v. in 30 minfollowed by 100000 units/h for 72 h. This was followedby daily infusions of antithrombin III and continuous

It is well established that there is an increase in the incidence of cardiovascular mortality in patients with proteinuric renal disease. The magnitude of the increase in risk is unlikely to be explained by traditional risk factors for cardiovascular disease alone. Proteinuria itself may constitute an additional risk factor, and proteinuric patients are known to have a degree of endothelial dysfunction. The nature of this relationship between proteinuria and endothelial function is the subject of intense investigation.The aim of this study was to examine the relationship between proteinuria and endothelial dysfunction, as reflected by serum von Willebrand factor (vWF), and the soluble cell adhesion molecules VCAM and ICAM, in patients with primary glomerulonephritis (GN). A secondary aim was to discern whether any relationship could be explained by renal function, lipid profile, inflammation or blood pressure.A cross-sectional study was undertaken in consecutive patients attending a general nephrology clinic with biopsy-proven primary GN. Patients with end-stage renal disease (ESRD), those on immunosuppressive drugs, or with intercurrent infective illnesses were excluded. Blood pressure and body mass index were recorded. Routine lab assays were undertaken for serum creatinine, lipid profile, and 24-hour urinary protein (U(Prot)). Additional serum samples were stored at -80 degrees C for subsequent measurement of vWF, VCAM, ICAM and sensitive C reactive protein (sCRP).Data were collected from 129 (86 male) patients. Mean (standard deviation) estimated creatinine clearance was 64 (32) ml/min, and median (interquartile range) 24-hour proteinuria was 1.1 (0.22-2.9) g. Mean vWF was 173 (68) IU/dl, median VCAM, ICAM and sCRP were 594 (410-708) ng/ml, 235 (208-286) ng/ml, and 2.33 (0.83-5.68) mg/l, respectively. There was a significant positive correlation between vWF and U(Prot) (Spearman rank correlation, r = 0.41, p0.001). When split into tertiles, according to U(Prot) (0-500 mg, 500-2000 mg, and2000 mg), there was a significant, stepwise increase in mean vWF (p0.001), log VCAM (p0.001), and log ICAM (p = 0.002). On multivariate analysis with vWF as the continuous dependent variable, U(Prot), age, total cholesterol and sCRP were the only significantly independent correlates (model-adjusted R2 = 33%).In patients with primary GN, there is a significant association between endothelial activation as reflected by vWF, VCAM, or ICAM and increasing proteinuria. Elevations in vWF, as well as being related to classical risk factors, are associated with increases in total proteinuria and low-grade inflammation. Thus, future prospective studies should examine the extent to which vWF and other circulating markers of endothelial activation predict coronary heart disease risk in patients with proteinuric renal disease.

Using Steiner’s silver stain a bacterium with spiral to curved morphology was observed in livers of control A/JCr mice with hepatitis, hepatic adenomas and hepatocellular carcinomas1. A Gram-negative bacterium with bipolar, single-sheathed flagella, isolated from these mice with diseased livers, maintained on a long-term carcinogenicity study, was characterized and named H. hepaticus 2. Since its original observation in A/JCr mice in 1991, H. hepaticus is now known to be prevalent in many mouse colonies, commercial and academic, throughout the world3. In addition to A/JCr mice, H. hepaticus causes hepatitis in BALB/cCr, SJL/NCr, SCID/NCr, C3H/ HeNCr mice and AxB recombinant strains. Like AJ/CR mice, H. hepaticus infection in B6C3F1 and AxB mice is associated with liver cancer. Because H. hepaticus’ ecological niche is the lower bowel, and the organism can also be readily isolated from the faeces, faecal-oral transmission is suspected. For example, H. hepaticus was isolated from either the caecum or the colon of 100% of A/JCr mice surveyed during a longitudinal study4. Thus, for routine diagnosis of H. hepaticus infection in infected mice, isolation should be attempted from the distal part of the intestine, not the liver parenchyma. The persistent nature of the infection, usually without overt clinical signs in wild-type mice, may in part contribute to the high prevalence of H. hepaticus in commercial and academic mouse colonies3,5. Recently, because of the negative impact of Helicobacter infections on biomedical research, considerable effort has been expended to derive Helicobacter-free colonies at several commercial vendors in the United States.

Helicobacter hepaticus infection causes hepatitis in A/JCr mice but mild or no disease in C57BL/6 mice. Colonization of H. hepaticus in the cecum of experimentally infected A/JCr and C57BL/6 mice was quantified by use of real-time polymerase chain reaction (PCR) analysis with primers for the H. hepaticus cdtB gene and mouse 18srRNA. Eight-week-old mice were experimentally (n = 48) or sham (n = 24) infected with H. hepaticus, then were necropsied 6 months after infection. Liver specimens from experimentally infected mice had negative results of PCR analysis for H. hepaticus; thus, real-time quantification was not attempted. Quantitative PCR analysis of H. hepaticus in cecal specimens indicated that C57BL/6 mice were colonized to a greater extent than were A/JCr mice (P0.006). Appreciable typhlitis was not observed, but was consistent with that of previous reports; A/JCr mice developed more severe parenchymal necrosis, portal inflammation, and phlebitis in the liver (P0.0001), with mild disease observed in infected C57BL/6 mice. Thus, hepatitis in A/JCr mice caused by H. hepaticus infection is associated with significantly lower colonization levels of H. hepaticus in the cecum, compared with those of hepatitis-resistant C57BL/6 mice. Host responses of A/JCr mice that limit cecal colonization with H. hepaticus may have important roles in the pathogenesis of hepatic lesions.

Zebrafish (Brachydanio rerio) have become an important model system for studying vertebrate embryonic development and gene function through manipulation of genotype and characterization of resultant phenotypes. An established research zebrafish colony without substantial disease problems for more than 7 years of operation began experiencing appreciable mortalities in November of 1997. Young fish (fry), from five to 24 days after hatching, spontaneously developed elongate strands of organic material protruding from the mouth, operculum, and anal pore, leading workers in the laboratory to describe the infected fish as "bearded." Unlike typical freshwater fish fungal infections, the skin surface did not have evidence of fungal colonization. The disease was associated with progressive lethargy, reduced feeding, and subsequent mortality. From 10 to 100% of the fry in a given tank were affected. Initial examination indicated that the biofilm around the head of affected fry consisted of bundles of septate fungal hyphae, large numbers of mixed bacterial populations, and protozoans. Environmental samples of air and water in the laboratory were obtained to ascertain the source of the infective agent and to isolate and identify the fungus. A fungus identified as Lecythophora mutabilis was isolated repeatedly from infected fish and water samples from infected fish tanks, and from the main laboratory water supply tanks, but not from laboratory air. Some biofilm beards on fish were found to consist of relatively pure bacterial populations, and beards on occasional fish examined in the later part of the study consisted of hyphae and spores of the oomycete genus Aphanomyces. Lecythophora mutabilis did not invade tissues; however, elimination of the epizootic correlated with reduction in the number of L. mutabilis conidia in the water following modification of the laboratory water system by use of new filtration and sterilization systems. We conclude that the dense hyphal strands of L. mutabilis composing the predominant biofilm type, along with mixed bacteria and protozoa, contributed to the die-off in young fry by occluding the oral cavity and/or gills, leading to starvation and/or asphyxiation.

Gastric dilatation (GD) has been observed in Tac:(SW)fBR surveillance mice, with mean age of 10 months, that are exposed to high levels of environmental antigens during routine exposure to dirty bedding. The aim of the study reported here was to determine whether GD was associated with other systemic conditions affecting mice. Three groups of nine animals including-surveillance mice not exposed to dirty bedding (control), surveillance mice with out GD (NGD), and surveillance mice with GD (group GD)-had mean stomach weight with ingesta of 0.5 +/- 0.02 g, 1.09 +/- 0.07 g (P0.0001), and 2.54 +/- 0.4 g (P0.0001), respectively. Mean serum creatinine concentration was significantly higher in GD (1.6 +/- 0.25 mg/dl), compared with NGD (0.17 +/- 0.22 mg/dl, P0.0001) and control (0.2 +/- 0.16 mg/ dl, P0.0001) mice. In addition, lesions consistent with severe chronic nephropathy and mild gastritis were common in GD, compared with NGD and control mice. Finally, serum amidated gastrin concentration was significantly high in GD (179.37 +/- 53.86 pM, P0.03) and NGD (264.89 +/- 115.89 pM, P0.009), compared with control (60.77 +/- 8.39 pM) mice. Gastric dilatation syndrome is associated with chronic nephropathy, hypergastrinemia, and gastritis in surveillance mice exposed to high levels of environmental antigens.

Two established zebrafish colonies experienced increased mortality and decreased reproductive performance. Initial examination of several fish from one facility revealed hyperemic gills, petechia around the opercula, abdominal distention, and emaciation. Affected fish had congested liver with inflammation and multifocal hepatic necrosis. Large numbers of acid-fast-positive, rod-shaped bacteria were evident in multiple tissues and the blood. Mycobacterium fortuitum was subsequently isolated from several fish. Zebrafish from the second facility had skin erosions and ulceration along the flank just caudal to the pectoral fins. Large numbers of acid-fast-positive, rod-shaped bacteria were observed within the necrotic centers of well-demarcated, multifocal granulomas in gonads, liver, and peritoneum from affected fish. Mycobacterium abscessus and M. chelonae were isolated and identified biochemically. Definitive diagnosis in these outbreaks was obtained by culture on selective media. Because Mycobacterium spp. grow extremely slowly and positive confirmation may require 45 to 60 days, Mycobacterium species-specific polymerase chain reaction analysis was used to provide a rapid screening assay for Mycobacterium spp. as well as for verification of culture results. To our knowledge, this is the first documentation of mycobacterial infection in laboratory-maintained zebrafish and provides guidelines for diagnosis, management, and prevention of atypical mycobacteriosis in laboratory zebrafish colonies.

Activation of inflammatory gene expression by the transcription factor NF-kappaB is a central pathway in many inflammatory disorders, including colitis. Increased NF-kappaB activity has been linked with development of colitis in humans and animal models, thus it was unexpected when NF-kappaB-deficient mice developed spontaneous typhlocolitis. To further characterize this finding, we induced typhlocolitis in rederived NF-kappaB-deficient mice using intragastric infection with Helicobacter hepaticus. At 6 wk postinfection (PI), severe colitis with increased type 1 cytokine expression was seen in infected mice that lacked the p50 subunit of NF-kappaB and were also heterozygous for the p65 subunit of NF-kappaB(p50(-/-)p65(+/-)). Mice lacking the p50 subunit alone (p50(-/-)) were less severely affected, and wild-type mice and p65(+/-) mice were unaffected. T cell development in NF-kappaB-deficient mice was normal. These data indicate that p50 and p65 subunits of NF-kappaB have an unexpected role in inhibiting the development of colitis.

Spontaneous animal mutants affected by abnormal formation of myelin in the central nervous system (CNS) are useful in studies on myelinogenesis and remyelination leading to better understanding of cellular and molecular interactions involved in myelin repair. A novel rat mutant, Bouncer Long Evans (LE-bo) is severely dysmyelinated, but with exceptional longevity, and its clinical and pathologic phenotype are described.Clinical observations, genetic studies, and determination of longevity were performed in a colony of rats, including carriers of LE-bo phenotype producing the mutant animals. Comprehensive histologic studies were performed on all perfusion-fixed tissues, and ultrastructural examination of the optic nerve and thoracic part of the spinal cord also was done in rats 1 to 14 weeks old.The LE-bo phenotype is characterized by whole body tremor, progressively severe ataxia, and severe seizure activity. The LE-bo phenotype is transferred as an autosomal recessive trait and is stable. The LE-bo rat can survive in good health beyond 45 weeks. Neuropathologic changes include severe global dysmyelination, with thin uncompacted myelin sheaths in young rats forming no major dense line, whereas the myelin sheaths of the peripheral nervous system appear normal. Oligodendrocytes degenerate with apparently progressing accumulation of membranous material in the perikaryon. Large numbers of immature glial cells were detected in the CNS of LE-bo rats at 4 to 14 weeks.The LE-bo rat is severely dysmyelinated due to inability of its oligodendrocytes to form myelin sheaths. Similarities of the LE-bo rat and Long Evans Shaker (les) rat neuropathologic features, such as severe dysmyelination, lack of major dense line in uncompacted myelin sheaths, apparent proliferation of oligodendroglial cells, and considerable longevity, are striking and suggest that a LE-bo mutation may functionally affect the myelin basic protein gene.

To determine the prevalence of colonization by Corynebacterium ulcerans, we cultured samples from the cephalic implant-skin margin and pharynx of 26 rhesus macaques and one pig-tailed macaque. All but one of the samples from the cephalic implants yielded a mixed population of bacteria. C. ulcerans grew from the cephalic implants in 56% and from the pharynx in 3% of the implanted animals. We screened nine of these isolates for diphtheria toxin (DT) and phospholipase D (PLD). Polymerase chain reactions (PCR) failed to identify DT in any of the tested isolates, which also lacked DT activity in Elek tests. However, all nine isolates tested had PLD toxin activity as determined by conjoint hemolysis on sheep blood agar plates in the presence of equi factor (Rhodococcus equi). In addition, PCR assays and Southern blot hybridization confirmed the presence of pld in the isolates. The role of the PLD toxin in promoting colonization of cephalic implants by C. ulcerans is unknown. We found C. ulcerans to be a frequent contaminant of the cephalic implant-skin margin. Further studies are necessary to investigate the relative clinical importance of this organism and the efficacy of various implant maintenance protocols in preventing infection.

Natural infection of research mice with enterohepatic Helicobacter spp. is common and may confound experimental studies from intercurrent disease. We evaluated a protocol of dirty bedding exposure for transmission of Helicobacter infection from colony mice to female Tac:(SW)fBR sentinel mice over 6 months.Cecal scrapings from culled colony mice and associated sentinel mice were tested for H. hepaticus, H. rodentium, and H. bilis using polymerase chain reaction analysis (PCR). These results were correlated with the results of sentinel serum IgG responses measured by ELISA.In 9 colony rooms, 43 of 45 mice were infected with H. hepaticus; in 14 rooms, 58 of 70 mice were infected with H. rodentium; and in 2 rooms, 2 of 10 mice were infected with H. bilis. Concurrence of Helicobacter infection between colony and sentinel mice was 82% for H. hepaticus, 88% for H. rodentium, and 94% for H. bilis. Concurrence of Helicobacter infection status of sentinel cagemates was 98% for H. hepaticus, 86% for H. rodentium, and 95% for H. bilis. Fecal samples pooled by sentinel cage had positive PCR results for H. hepaticus and H. rodentium at 1 month in 60 and 44%, respectively, of the cages that contained test-positive mice at necropsy (6 months). By 3 months, detection rates were 100 and 81% for H. hepaticus and H. rodentium, respectively, and H. bilis was not detected until 4 months. Newly acquired infections with H. rodentium and H. bilis were evident throughout the 6-month study period. Seroconversion was coincident with positive PCR results in sentinel mice, and serum IgG values continued to increase until necropsy. The serum IgG ELISA was 98 to 100% sensitive, but was low in specificity (34 to 44%), most likely attributable to common coinfection with H. hepaticus and H. rodentium.Sentinel mice acquire infection with Helicobacter spp. through dirty bedding exposure. Combined use of PCR analysis and serologic testing of sentinel mice was predictive of Helicobacter infection status of mouse colonies used for biomedical research.

Altered gastrin expression associated with Helicobacter pylori infection may contribute to the pathogenesis of peptic ulcer disease or gastric cancer in man, but gastrin has not been investigated in a murine model of Helicobacter infection. C57BL/6 mice were inoculated with Helicobacter felis and examined after 4-21 weeks for G and D cell numbers, antral gastrin and somatostatin mRNA, and luminal pH. In H. felis-infected mice, gastrin mRNA declined at four and six weeks after infection to 57% and 23%, respectively, of uninfected control values. Concurrently, somatostatin mRNA showed no change at four weeks and a modest 25% decrease at six weeks after infection. Similar reductions were noted in G and D cell numbers, resulting in a decrease in the G/D cell ratio after mice were infected with H. felis. Infected animals also showed a loss of parietal and chief cells, and an increased gastric pH. H. felis infection in C57BL/6 mice leads to an early suppression of G cell number and gastrin mRNA. These changes precede an alteration in somatostatin cell number and mRNA and, coupled with reductions in parietal and chief cells, may contribute both to severe impairment of gastric acid output and the potential for carcinogenic processes.

To determine whether ranitidine bismuth citrate, clarithromycin, or a combination of ranitidine bismuth citrate and clarithromycin would be efficacious in eradication of Helicobacter mustelae infection in ferrets.60 seven-month-old ferrets.To determine dosages of clarithromycin and ranitidine bismuth citrate that would suppress growth of, but not eradicate infection with, H mustelae, ferrets (n = 6/group) were treated p.o. with clarithromycin or ranitidine bismuth citrate at various dosages. Efficacy of treatment was then determined by treating ferrets with clarithromycin alone, ranitidine bismuth citrate alone, or clarithromycin and ranitidine bismuth citrate. Gastric biopsy specimens were obtained before, during, and at various times after treatment and submitted for quantitative bacterial culture and histologic evaluation. Minimum concentrations of clarithromycin that inhibited 90% of the growth of isolates obtained before and after treatment were determined.Dosages of clarithromycin and ranitidine bismuth citrate that suppressed growth of H mustelae were 12.5 and 24 mg/kg of body weight, p.o., every 8 hours, respectively. Infection was not eradicated in ferrets treated with ranitidine bismuth citrate alone but was eradicated in all 6 ferrets treated with clarithromycin and ranitidine bismuth citrate and in 4 of 6 treated with clarithromycin alone. A decrease in susceptibility to clarithromycin was detected for H mustelae isolates obtained after treatment. Mild or moderate antral gastritis was observed even in ferrets from which infection was eradicated.A combination of ranitidine bismuth citrate and clarithromycin was efficacious in eradicating H mustelae infection from ferrets.

Since the discovery of Helicobacter pylori it is becoming increasingly clear that the genus Helicobacter is composed of numerous species, many of which can produce serious disease in their respective hosts. The genus now includes 20 named species and at least 30 unnamed species. This number will undoubtedly increase as culture methods improve for these fastidious microaerobes. Importantly, more novel Helicobacters will be recognized as well as their pathogenic potential realized, as the index of suspicion increases that these organisms can indeed cause a plethora of gastrointestinal diseases. The enterohepatic helicobacters (EHS) are distinct phylogenetically from the gastric helicobacters and also, as the name implies, are capable of colonizing the lower bowel and hepatobiliary tissue, but rarely the stomach (Table 1). The purpose of this chapter is to discuss the various EHS, particularly those infecting hepatobiliary tissue and, where known, detail their host range, epidemiology and pathogenic potential. The best known of the EHS, H. hepaticus, will be reviewed in greater detail, with the prediction that many of the salient features of this newly recognized pathogen will also be relevant to our evolving understanding of the EHS in general.

Helicobacter mustelae is a urease-rich bacterium associated with gastritis in ferrets. The ureases of H. mustelae and Helicobacter pylori, a bacterium implicated in human gastritis, share many characteristics. Helicobacter sp. ureases appear to be unique among bacterial enzymes in exhibiting submillimolar Km values and in being composed of two subunits.

A high-salt diet in humans and experimental animals is known to cause gastritis, has been associated with a high risk of atrophic gastritis, and is considered a gastric tumor promoter. In laboratory rodents, salt is known to cause gastritis, and when coadministered, it promotes the carcinogenic effects of known gastric carcinogens. Because Helicobacter pylori has been associated with a progression from gastritis to gastric cancer, we designed a study to determine whether excessive dietary NaCl would have an effect on colonization and gastritis in the mouse model of H. pylori infection. Seventy-two, 8-week-old female C57BL/6 mice were infected with H. pylori strain Sydney, and 36 control mice were dosed with vehicle only. One-half of the infected and control mice were fed a high-salt diet (7.5% versus 0.25%) for 2 weeks prior to dosing and throughout the entire experiment. Twelve infected and 6 control animals from the high-salt and normal diet groups were euthanized at 4, 8, and 16 weeks. At 8 and 16 weeks postinfection (WPI), the colony-forming units per gram of tissue were significantly higher (P0.05) in the corpus and antrum of animals in the high-salt diet group compared with those on the normal diet. Quantitative urease was significantly higher (P0.05) at 4 and 8 WPI in the corpus and antrum of animals on the high-salt diet when compared with controls. At 16 WPI, mice in both the normal and the high-salt diet groups developed moderate to marked atrophic gastritis of the corpus in response to H. pylori infection. However, the gastric pits of the corpus mucosa in mice on the high-salt diet were elongated and colonized by H. pylori more frequently than those in mice on the normal diet. The high-salt diet was also associated with a significant increase in proliferation in the proximal corpus and antrum and a multifocal reduction in parietal cell numbers in the proximal corpus, resulting in the elongation of gastric pits. We conclude that excessive NaCl intake enhances H. pylori colonization in mice and in humans and that chronic salt intake may exacerbate gastritis by increasing H. pylori colonization. Furthermore, elevated salt intake may potentiate H. pylori-associated carcinogenesis by inducing proliferation, pit cell hyperplasia, and glandular atrophy.

An outbreak of diarrhea spanning 3 months occurred in a breeding colony of scid/Trp53 knockout mice. Approximately a third of the 150 mice were clinically affected, with signs ranging from mucoid or watery diarrhea to severe hemorrhagic diarrhea with mortality. Helicobacter bilis and the newly recognized urease-negative organism H. rodentium were isolated from microaerobic culture of feces or cecal specimens from affected mice. Dual infection with H. bilis and H. rodentium were confirmed by culture and polymerase chain reaction (PCR) in several animals. Both Helicobacter species rapidly colonized immunocompetent sentinel mice exposed to bedding from cages containing affected mice, but the sentinel remained asymptomatic. Mice with diarrhea had multifocal to segmental proliferative typhlitis, colitis, and proctitis. Several affected mice had multifocal mucosal necrosis with a few focal ulcers in the cecum, colon, and rectum. Mice with diarrhea were treated with antibiotic food wafers (1.5 mg of amoxicillin, 0.69 mg of metronidazole, and 0.185 mg of bismuth/mouse per day) previously shown to eradicate H. hepaticus in immunocompetent mice. Antibiotic treatment resulted in resolution of diarrhea, but not eradication of H. bilis and H. rodentium; mice continued to have positive PCR results after a 2-week treatment regimen, and clinical signs of diarrhea returned in some mice when treatment was suspended. To the authors' knowledge, this is the first report of natural infection with either H. bilis and/or H. rodentium causing acute diarrheal disease and suggests that H. bilis and/or H. rodentium can be an important pathogen for scid mice.

Murine ascites production has been associated with appreciable morbidity and mortality, thus raising animal-welfare concerns. To address these concerns, the clinicopathologic changes associated with in vivo production of monoclonal antibodies in mice were characterized, and results were compared among cell lines.Five hybridoma cell lines were grown in groups of 20 mice. Fourteen days prior to inoculation with 10(6) hybridoma cells, mice were primed with 0.5 ml of pristane given intraperitoneally; 12 mice were sham treated (controls). Ascites fluid was collected a maximum of three times by abdominal paracentesis. Clinical observations and pre- and postabdominal tap body weights were recorded. Necropsies were performed on all mice.For all groups combined, overall survival to tap 1 was 98%, to tap 2 was 96%, and to tap 3 was 79%; survival among groups ranged from 90 to 100% for tap 1, 85 to 100% for tap 2, and 35 to 100% for tap 3. Disseminated intra-abdominal seeding with irregular soft tissue and/or solid tumor masses was observed at necropsy.Significant clinicopathologic changes were associated with monoclonal antibody production in mice, and differences between various hybridoma cell lines were apparent.

Helicobacter pylori infection has been linked to the development of gastritis which can then progress to a number of disease entities including peptic ulcer disease and gastric cancer. Since the pathogenic mechanism by which the bacteria causes gastritis is unresolved, we employed a model system, the H. felis-infected mouse to investigate the temporal relationship between bacterially-induced alterations in the hydrophobic phospholipid barrier of the stomach and the development of gastritis. In the present study, C57BL/6 mice were inoculated with 10(9) CFU of H. felis and the changes in gastric wet weight, histology, surface hydrophobicity, phospholipid/phosphatidylcholine concentration, phospholipase A2 activity, and the pH of collected gastric juice were measured 0.5-2 months postinoculation. In related experiments, we investigated the effects of treating H. felis infected mice with antibiotic/ bismuth therapy on the above gastric properties. It was determined that both gastric surface hydrophobicity and phospholipid composition were significantly attenuated as early as 2-4 weeks postinfection, preceding signs of mucosal inflammation and glandular atrophy as indicated by increases in gastric wet weight, pH and a disappearance in parietal cells. These early H. felis-induced changes in gastric surface hydrophobicity and phospholipid concentration were reversed by antibiotic/bismuth therapy. Based on these results we conclude that H. felis infection induces an early transformation of the stomach from a hydrophobic to an acid-sensitive hydrophilic state that may trigger the subsequent development of gastritis.

To investigate a potential new treatment for gastric Helicobacter pylori infection, we have examined the use of the natural antibiotic lactoferrin, found in bovine milk, for activity against Helicobacter species both in vitro and in vivo. Lactoferrin was bacteriostatic to H. pylori when cultured at concentrationsor =0.5 mg/ml. Growth of H. pylori was not inhibited by another milk constituent, lysozyme, or by a metabolite of lactoferrin, lactoferricin B, but growth was inhibited by the iron chelator deferoxamine mesylate. Lactoferrin inhibition of growth could be reversed by addition of excess iron to the medium. Lactoferrin in retail dairy milk was found to be more stable intragastrically than unbuffered, purified lactoferrin. Treatment of H. felis-infected mice with lactoferrin partially reversed mucosal disease manifestations. It is concluded that bovine lactoferrin has significant antimicrobial activity against Helicobacter species in vitro and in vivo. Bovine lactoferrin should be further investigated for possible use in H. pylori infections in man.

Previous studies have shown that inexperienced operators have a lower success rate than experienced operators for insertion of internal jugular cannulae using the anatomical landmark technique. The object of this study was to determine the rate of successful insertion, incidence of immediate complications and incidence of infection for temporary hemodialysis cannulae inserted under ultrasound guidance by experienced and inexperienced operators.The reason for insertion, patient age, reason for failed insertion, immediate complications, duration of cannula survival and reason for removal were recorded prospectively for 107 attempted cannulations by 7 operators in 72 subjects with renal failure. Operators were defined as "experienced" (more than 3 years postgraduate clinical experience and more than 25 previous central vein cannulae inserted) or "inexperienced" (less than 3 years postgraduate clinical experience and less than 3 previous central vein cannulae inserted). Rates of successful cannulation and incidence of complications were compared for experienced and inexperienced operators. Cannula survival without infection was analysed by Kaplan-Meier survival for experienced and inexperienced operators.The overall success rate of cannula insertion at first site was 103/107 (96.3%) with no difference between experienced and inexperienced operators (56/58 vs. 47/49). 103 internal jugular temporary haemodialysis cannulae were inserted into 72 subjects. The only immediate complication was incorrect positioning of the cannula in 6 cases requiring manipulation. The median survival of hemodialysis cannulae was 14 days (range 1-111). 64.1% cannulae functioned for as long as required. Of the remainder, 33/36 were removed because of presumed cannula related infection. There was no difference in the median duration of cannula survival between experienced and inexperienced operators (15 days versus 12 days; Mann-Whitney point estimate = -1.00; 95% confidence interval -6.00, 3.00). p = 0.66) or in the probability of cannula survival without infection by Kaplan Meier analysis.We conclude that ultrasound guided temporary haemodialysis cannulation is a safe procedure with a high rate of success, the success rate for inexperienced operators is much higher than previous studies of cannulation using the anatomical landmark technique and the rate of cannula removal due to infection is not influenced by operator experience.

To determine the phenotype of naturally developing lymphomas in young ferrets.10 ferrets with lymphoma.Neoplastic tissues were graded histologically according to the National Cancer Institute's Working Formulation for non-Hodgkin's lymphoma and phenotype was determined by means of immunohistochemical staining. A polyclonal anti-human CD3 and a monoclonal anti-human CD79 antibody were used to classify the lymphomas in situ as T-cell or B-cell origin. Specificity of antibodies was determined by evaluating lymphoid tissue from normal ferrets in situ, which was confirmed by western blot analyses.All 10 ferrets had clinically aggressive tumors, irrespective of the phenotype. Nine ferrets had T-cell lymphoma that extensively involved the mediastinum. Remnants of thymic tissue, indicative of thymic origin, were identified in lymphoma of these 9 ferrets. One ferret had a B-cell multicentric lymphoma without involvement of the mediastinum.The majority of lymphomas in these young ferrets involved the mediastinum and were of T-cell phenotype. Impact for Human Medicine-There are many similarities between the lymphoma syndrome of ferrets and the condition documented for cats and children with lymphoma of the mediastinal area.Differential diagnoses for young ferrets with clinical signs of lethargy or respiratory distress should include T-cell lymphoma of the mediastinum.

Although gastric cancer is an uncommon spontaneous neoplasm of laboratory animal species, rodents, and to a lesser extent other animals, have been used in chemically induced gastric carcinogenesis studies for decades. The role of diet in preventing or promoting gastric cancer has also been addressed in animal models. With the discovery of Helicobacter pylori and its causative role in gastric disease in humans, several animal models have been described for Helicobacter spp.-induced gastric disease, and in selected models, development of gastric and hepatic cancer. This review has attempted to highlight salient features of Helicobacter models and how these observations may be interpreted in light of data obtained from chemical carcinogenesis and nutritional studies. Further insight into mechanisms of Helicobacter-induced cancer should evolve by combining and comparing relevant features of these in vivo models.

To determine incidence of neoplastic disease in ferrets.Retrospective study.574 ferrets with neoplastic disease.Medical records from the Veterinary Medical Data Base at Purdue University from 1968 to May 1997 were reviewed to identify ferrets with neoplastic disease. Data on tumor type, organ or system affected, sex, age, geographic location of affected ferrets, participating institution, and year of diagnosis were retrieved.639 tumors of various types were diagnosed in 574 of 4,774 (12%) ferrets in the database. Sixty-one ferrets had multiple tumor types. Primary tumors were found in every system; endocrine (254; 39.7%), hemolymphatic (97; 15.2%), integumentary (83; 12.9%), and digestive (54; 8.4%) systems were most commonly affected. The most common tumor types were pancreatic islet cell (139; 21.7%) and adrenocortical cell (107; 16.7%) tumors and lymphoma (76; 11.9%). Most (94.2%) pancreatic islet cell tumors were functional. Age of affected ferrets ranged from less than 1 month to more than 15 years old. Tumor incidence was highest in ferrets between 4 and 7 years old. A sex predilection was not found, although tumors were found more commonly in spayed females and castrated males than in sexually intact females and males, respectively. Number of tumors diagnosed increased as the number of ferrets examined increased. Neoplastic disease accounted for an increasingly greater percentage of diseases diagnosed in ferrets during the study period.Ferrets have an incidence and spectrum of neoplastic disease similar to other mammalian species.

Helicobacter pylori infection and adenomatous polyposis coli (Apc) gene mutations have been linked to gastric cancer in humans, but possible synergistic interaction(s) between these risk factors have not been examined. Fourteen C57BL/6 wild-type and 14 Apc1638 heterozygous mice were inoculated with Helicobacter felis at 6 weeks of age and compared at various time points with a similar number of uninfected control mice of the same genotype. Both infected and uninfected Apc1638 mice had a limited incidence of atypical proliferation foci in the mucosa of the antrum and pyloric junction at 4.5 and 6 months of age, whereas polyps of the antrum and pylorus were present in all mice, regardless of infection status, at 7.5 months. In contrast, no altered gastric mucosal foci were observed in control or infected C57BL/6 mice at any time point. Interestingly, the infected Apc1638 mice had less epithelial proliferation and inflammation in the body of the stomach, lower anti-H. felis serum IgG antibody responses (although both the wild-type and Apc mutant mice had a Th1-like immune response, based on a predominantly IgG2a immunoglobulin response), and higher bacteria and urease scores than did infected wild-type C57BL/6 mice. In conclusion, the Apc1638 truncating mutation leads to gastric dysplasia and polyposis of the antrum and pyloric junction, but H. felis infection of the Apc mutant mouse does not lead to an increased rate of gastric neoplasia. In addition, our data suggest this Apc mutation may actually lead to decreased immune, inflammatory, and gastric hyperplastic responses to Helicobacter infection, suggesting the possibility of a novel role for this tumor suppressor gene in the immune and local tissue responses to gastric bacterial infection.

To address the physiologic mechanism of isoflurane-associated reduction in hematologic variables in ferrets.6 young adult female ferrets.Distribution of 99mTc-labeled autologous erythrocytes was measured by serial in vivo imaging. Data were recorded in 4 ferrets, using a gamma camera, immediately prior to anesthesia, 15 minutes after 2% isoflurane anesthesia in O2 via endotracheal tube, 1 minute prior to and throughout a 10-minute phenylephrine infusion, 20 and 40 minutes after termination of the phenylephrine infusion, and 45 minutes after termination of anesthesia. Blood indices were also measured at times that paralleled those for imaging. One ferret served as a conscious control (no anesthetic administration), and another as an isoflurane control (no phenylephrine administration).In ferrets under anesthesia, splenic radioactivity increased from baseline of 10.2 +/- 2.0% to 38.4 +/- 3.2% (mean +/- SEM; P0.05) of the injected dose. Splenic radioactivity decreased to 13.4 +/- 3.8% of the injected dose during phenylephrine infusion and to near baseline for the recovery image. Splenic radioactivity in the conscious control remained constant throughout the study, whereas that of the anesthetized control was persistently increased throughout administration of isoflurane. Percentage reduction of the 15-minute sample values, compared with baseline values for all hematologic indices, was: RBC count, 33% (P0.05); hemoglobin concentration, 34% (P0.05); hematocrit, 35% (P0.05); and plasma protein concentration, 20% (P0.05). All RBC variables returned to within 7 to 14% of baseline by 45 minutes after termination of anesthesia.Isoflurane anesthesia causes splenic sequestration of RBC in ferrets that is partially reversed by phenylephrine infusion or termination of anesthesia. Thus, investigators and clinicians should be cautious when interpreting hematologic findings in isoflurane-anesthetized ferrets, and accordingly, fluid treatment and transfusion should be planned.

Gastric lymphoma resembling gastric mucosa-associated lymphoid tissue (MALT) lymphoma linked with Helicobacter pylori infection in humans was observed in ferrets infected with H. mustelae. Four ferrets with ante- or postmortem evidence of primary gastric lymphoma were described. Lymphoma was diagnosed in the wall of the lesser curvature of the pyloric antrum, corresponding to the predominant focus of H. mustelae induced gastritis in ferrets. Two ferrets had low-grade small-cell lymphoma and two ferrets had high-grade large-cell lymphoma. Gastric lymphomas demonstrated characteristic lymphoepithelial lesions, and the lymphoid cells were IgG+ in all ferrets. Lymphoma was confirmed by light chain restriction, which contrasted with the 1.2:1 kappa lambda ratio observed in H. mustelae-associated chronic gastritis. H. mustelae infection in ferrets has been used as a model for gastritis, ulcerogenesis, and carcinogenesis. The ferret may provide an attractive model to study pathogenesis and treatment of gastric MALT lymphoma in humans.

The microbial flora of stomachs of humans and animals have been the focus of considerable research since the discovery that Helicobacter pylori in humans caused a variety of gastric diseases. Other Helicobacter species have now been isolated from the stomachs of various mammals, including dogs, cats, ferrets, pigs, monkeys, and cheetahs, all of which are associated with various degrees of gastritis in their hosts. Helicobacter species have also been isolated from the intestinal tracts of humans, animals, and birds. Helicobacter species have not only been isolated from intestines of mice but have, in addition, been isolated from diseased livers of inbred and outbred mice, and one of these, H hepaticus is linked to liver tumors. H canis and H pullorum isolated from dogs and chickens, respectively, have also been cultured from feces of diarrheic humans. H fennelliae and H cinaedi are two additional helicobacters primarily associated with lower bowel disease in immunocompromised humans. To date, there are at least 13 formally named species of the new genus, Helicobacter, the majority being proven or suspected gastrointestinal or hepatic pathogens. Several of these helicobacters have zoonotic potential as well. It is predicted that additional Helicobacter species will be identified, and they, too, may be important pathogens in humans and animals.